| NPI | 1376695551 |
|---|---|
| Other Name | LAKE STEVENS |
| Entity Type | Organization |
| Authorized Contact | GEORGE GO Board President 425-259-0966 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2024-04-09 |