| NPI | 1386828846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN R WILSON Medical Assistant 425-806-8360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP30005666) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2023-04-11 |