| NPI | 1114410495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KEITH NAIBERT Owner 206-200-5867 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-01-01 |