| NPI | 1386774222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETA A TRAVIS Administrator 509-843-3412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: WA MD00025084) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-09-15 |