| NPI | 1134354533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN HOWARD PIASECKI Member 253-509-4438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA MD00049097) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2011-11-29 |