| NPI | 1255674842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN D SHAW Owner 425-258-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA NT00001544) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2013-04-01 |