| NPI | 1295990703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY LYLE FOX President 253-851-5138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WA CH0001303) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |