NPI | 1285908780 |
---|---|
Doing Business As | WALNUT GROVE MEDICAL |
Entity Type | Organization |
Authorized Contact | KELLY MARTENE BELL Partner 360-718-2515 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30005937) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30006359) |
Enumeration Date | 2012-02-29 |
Last Update Date | 2012-02-29 |