| NPI | 1366964959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN GRAYBILL Physician 360-314-2548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WA MD60544409) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2024-11-20 |