| NPI | 1093301418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER COBB Billing/Credentialing Manager 360-723-0528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-12-19 |
| Last Update Date | 2026-05-27 |