| NPI | 1467431726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE T FETROE Owner 509-522-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00018950) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30002544) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2007-10-20 |