| NPI | 1205352689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JEFFERSON DAWSON Cmo 509-222-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2023-08-30 |