| NPI | 1346383353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN ANN KEEGAN Office Manager 360-425-3854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA PY00001284) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |