| NPI | 1033457395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MCCULLUGH Managing Member 509-619-5936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60140231) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2013-01-22 |