| NPI | 1184838377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUARDO A GEMBS Co Owner 509-943-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA MD00042734) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-10-04 |