| NPI | 1285018432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA VAN FLEET-GREEN Owner/Md 360-556-8465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60162757) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-09-23 |