| NPI | 1346593746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DANIEL TRAVERS President 509-293-6809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00028342) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2013-02-20 |