| NPI | 1164746285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI L BAZE Practice Admin 509-737-1492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |