| NPI | 1467515015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE REITER Authorized Official 360-692-2728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602478678) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-10-23 |