| NPI | 1386817575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN LEE Officer 360-424-2112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA AP30000477) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2017-12-26 |