| NPI | 1255311122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM ELIZABETH PRUESS NEVINS Md Owner 425-391-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00038616) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2011-05-31 |