| NPI | 1396833919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL CARL HAECK Physician 206-464-0873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 6023535960010001) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |