| 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 |