| NPI | 1427352749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN CHILDRESS Owner 360-710-3319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30006700) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2014-02-17 |