| NPI | 1235471954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secreatry For Enrollment 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA 602580652) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA 602421635) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2025-09-22 |