| NPI | 1063622355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE EDWARD FOLTZ President 360-254-4402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 601417908) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |