| NPI | 1053594853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE KUCERA THOMPSON President 509-966-2961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: WA PY 2939) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: WA PY2939) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2008-02-01 |