| NPI | 1154457281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRILYNN NICKLIN Billing Manager 360-434-3009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00033163) |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2008-06-26 |