| NPI | 1144536079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN R SMITH Owner 360-352-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA 6935) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |