| NPI | 1124350814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMME DAVIS President 360-892-0208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA OP00001463) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |