| NPI | 1427621655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN PAUL CLEMENS Gove RN Or 360-634-8949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center Occupational Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2021-07-24 |
| Last Update Date | 2023-05-31 |