| NPI | 1184340184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JODENE SIMMONS Owner A RN P 360-931-1373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-12 |