| NPI | 1114957875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CLARENCE WILLIARD Physician 360-754-1029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD00029497) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA 601009261) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-05-31 |