| NPI | 1053798546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY 'KIMMER' VERLYNN COLLISON-RIS Owner/Provider 4252-104-1187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WA AP30006553) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |