NPI | 1194107847 |
---|---|
Entity Type | Organization |
Authorized Contact | ZHENBO LI Owner 360-798-4950 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA AC00002855) |
Enumeration Date | 2015-06-18 |
Last Update Date | 2015-06-18 |