| NPI | 1336693902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J. LANGEI Owner 360-927-9042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA 603616109) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: WA 603616109) |
| 363A00000X Physician Assistant (Licence: WA 603616109) | |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2019-04-25 |