| NPI | 1336176619 |
|---|---|
| Doing Business As | 28TH AVE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | VIVEK SHAH The Doctor 509-576-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA UBI No. 602 624 101) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-08-22 |