NPI | 1285174813 |
---|---|
Entity Type | Organization |
Authorized Contact | JUBILEE PEARL MATTIX Nurse Practitioner 360-201-0926 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60703570) |
Enumeration Date | 2017-03-01 |
Last Update Date | 2017-03-01 |