| NPI | 1205209913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM A WALTER Owner 425-745-4661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00005339) |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2015-11-03 |