| NPI | 1184840548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL E HANSEN President 253-858-9169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 8740) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-07-15 |