| NPI | 1376761528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PECK Owner 360-676-8707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WA 600050758) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2008-10-23 |