| NPI | 1184973828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE LELAND HORNER Owner 206-465-8046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MD153145) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-11-26 |