| NPI | 1457411811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE KNIPPEL Patient Care Coordinator 206-320-2270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MD00023270) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |