| NPI | 1124787635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET COLEMAN Pharmacist / Member 360-787-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-12-12 |
| Last Update Date | 2021-12-12 |