| NPI | 1144343773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI BRYANT Office Manager 360-892-1635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: WA 601 115 723) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-02-21 |