| NPI | 1083803696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GOTHMAN Chief Of Finance 509-434-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: WA AP30001879) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: WA ap30001879) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |