| NPI | 1083168272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARNIE L COLLINS Owner 509-927-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA 8149) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |