| NPI | 1023488343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2021-10-05 |