| NPI | 1356622344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON SCOTT PIERCE Owner 360-532-1360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WA MD60075926) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60075926) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2011-11-15 |