| NPI | 1194083956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A SUENO Member 253-302-5189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA MD60252648) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2013-04-24 |