| NPI | 1194032201 |
|---|---|
| Doing Business As | JEFFERSON HEALTHCARE WALK IN CLINIC |
| Entity Type | Organization |
| Authorized Contact | KATHY LEE PORTER Registration Coordinator 360-385-2200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA HAC.FS.00000085) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA HAC.FS.00000085) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-12-09 |