| NPI | 1235406877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DEICHERT Owner 206-795-5760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60178142) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2018-12-27 |