| NPI | 1124222559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA E FANSLOW A RN P 253-927-2130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP30004806) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2007-12-14 |