NPI | 1174995104 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON D WRIGHT Medical Director 509-792-1404 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA OP60504027) |
Enumeration Date | 2015-10-29 |
Last Update Date | 2019-03-20 |