| NPI | 1275866048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN MADSEN Credentialing COO Rdinator 509-290-6557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP00001511) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2021-08-03 |