| NPI | 1073402624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANYA ELLER Legal Assistant & Licensing Analyst 206-395-7870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |