| NPI | 1215082557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ANN BECKER Owner 360-825-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602061246) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2012-02-23 |