| NPI | 1104905306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZI M LUNDBERG Billing Manager 509-628-2843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00046273) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2010-07-21 |