NPI | 1104176007 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW HOWARD ROSE Physician 360-861-6433 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA op60287355) |
Enumeration Date | 2012-09-18 |
Last Update Date | 2014-03-19 |