| NPI | 1326346909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN D HAGEN Owner 425-672-1822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA ch00001795) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2011-03-07 |