| NPI | 1194047092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA PEARSON Credentialing Specialist 360-242-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 601061994) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2020-11-23 |