| NPI | 1164957288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA PAGE Office Manager 360-420-6474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: WA MD60251426) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 364SF0001X Clinical Nurse Specialist, Family Health | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |