| NPI | 1396793709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY BURGHART Executive Director 360-782-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2019-11-01 |