| NPI | 1376692129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE MARQUEZ Billing And Credentialing 509-225-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: WA PO00000565) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-05-04 |