| NPI | 1205168184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS A MYERS Managing Member 509-844-8184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: WA OD3853) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2019-08-02 |