| NPI | 1376549618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN WALLACE Practice Manager 253-759-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: WA FX00057086) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2020-08-22 |