| NPI | 1336129154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDNEY F WHALEY President 253-383-1529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA 10945) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA 10945) |
| 207ND0900X Dermatology, Dermatopathology (Licence: WA 10945) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2007-10-04 |