| NPI | 1346471091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYNE PHILIP BLEVINS Family Nurse Practitioner 509-868-8795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2009-07-29 |