| NPI | 1376519090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUCK STILLWAGGON Practice Administrator 509-834-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WA 602044113) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2023-01-26 |