| NPI | 1376703223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MICHAEL SMITH Associate 509-965-5750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA CH 60040319) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2008-10-21 |