| NPI | 1285918318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVERINE ELZBETH PUARIEA Owner 360-694-3021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA CH00000730) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |