| NPI | 1033424239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARITY CAMPBELL Credentialing 425-775-1505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: WA PO0000501) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: WA PO0000501) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |