| NPI | 1184091134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON ANN STANLEY Physician/Owner 360-746-8827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA OP60232157) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA OP60232161) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2016-06-28 |