| NPI | 1295073997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA ANTOINETTE SMITH Manager 425-313-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA 60192681) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2013-02-05 |