| NPI | 1396899340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA M EDKIN Office Manager 360-459-3663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 601961208) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2011-01-27 |