| NPI | 1104465012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA CAMPOS Credentialing Manager 206-215-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2024-01-12 |