| NPI | 1376871392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD CRAIGG Owner 509-301-9057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA 00044814) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |