| NPI | 1205250958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA MICHELLE MAHAN-SAWVELL Owner 360-829-0610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA CH60212280) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |