| NPI | 1255968996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA CLARK Member 360-275-2892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2023-11-01 |