| NPI | 1134218167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT KENTFIELD Administrator 360-736-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 600111876) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-06-02 |