| NPI | 1023624681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY CAMERON Owner 509-430-5885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-24 |