| NPI | 1295790970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH NOVAK Medical Director 360-457-1431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 600 628 919) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2009-01-20 |