NPI | 1316914278 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN G CARROUGHER Medical Director 253-272-8664 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0800X Clinic/Center, Endoscopy (Licence: WA FX00057739) |
Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA ASF.FX.60100031) |
Enumeration Date | 2006-02-28 |
Last Update Date | 2011-01-14 |