| NPI | 1215178835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE AUMAN Credentialing Specialist 360-242-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: WA ASFFS60101112) |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2022-07-18 |