| NPI | 1215091368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J DEGAN Medical Doctor 425-774-2636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA 601850391) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2011-12-12 |