| NPI | 1033399084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNAE WILSON Office Manager 509-736-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602776306) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2022-04-19 |