| NPI | 1316079254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE LYNN NASH Office Manager 253-446-0750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD00046263) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-03-07 |