| NPI | 1255351714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA EBERHARD Credentialing Specialist 360-706-2767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602208923) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-05-20 |