| NPI | 1427601467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY E WILLIAMS Manager, Provider Data & Enrollment 253-459-8009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology | |
| 2080P0214X Pediatrics, Pediatric Pulmonology | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 2080S0012X Pediatrics, Sleep Medicine | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-10-22 |