| NPI | 1306235049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BUCKLAND Owner 360-773-7463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2022-01-26 |