| NPI | 1366884835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE A GELLERSON Billing Specialist 425-646-7472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA MD00029775) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |