| NPI | 1164705794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREN LAYBOURN Administrator 360-533-1576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00046844) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |