| NPI | 1366846073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILNA JEAN WHEELER Administrator 360-581-8949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA OP00001975) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA OP00002338) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60335345) | |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |