| NPI | 1114241478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRY JEAN KAHLSTROM A RN P 253-389-6998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: WA 60128007) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |