| NPI | 1417036849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISE LEAF LELAND President 360-567-0488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00044580) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60285535) |
| 213E00000X Podiatrist (Licence: WA P0515) | |
| Enumeration Date | 2006-11-05 |
| Last Update Date | 2015-10-19 |