| NPI | 1083949374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN L GOTT Account Manager 509-926-1770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00029097) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 602935992) |
| 207Q00000X Family Medicine (Licence: WA OP00001703) | |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2014-12-04 |