| NPI | 1114316494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLANDO TANTOCO Provider/Owner 206-801-7174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: WA 750929) |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-01-09 |