| NPI | 1093237737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKI PETHES Credentialing Coordinator 425-277-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2017-07-14 |