NPI | 1316079585 |
---|---|
Entity Type | Organization |
Authorized Contact | T KENT VYE President 509-452-2508 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA 0P00001175) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 0P00001175) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2008-10-15 |