| NPI | 1265592240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA MAY MCGOVERN President 360-417-8630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10004257) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00038097) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2025-09-11 |