| NPI | 1174710966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND PARK Owner 425-822-1214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA 602756604) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2008-02-29 |