| NPI | 1124476833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL M. THOMPSON Credentials Technician 253-968-0758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA RN60164202) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |