| NPI | 1033320007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEE CAULKINS Owner 360-373-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP00001096) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA OA10000192) |
| 363L00000X Nurse Practitioner (Licence: WA AP3004792) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2008-06-25 |