| NPI | 1417469404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIMBOLU MAKINDE Owner 425-286-8271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WA 60465979) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |