NPI | 1063617967 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC DANIEL THOMAS Physician 360-923-1111 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: WA op00001758) |
Enumeration Date | 2007-06-19 |
Last Update Date | 2008-06-30 |