| NPI | 1336167246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MAGISTRALE Executive Director 360-750-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |