| NPI | 1225054141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT LITVIN Administrator 360-735-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2008-06-20 |