| NPI | 1184607061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY AARON RICHBERG Administrator/Director/Managing Emp 360-788-7750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602068145001) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2018-07-27 |