| NPI | 1467649376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD WISNER Delegated Official 360-676-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: WA 16552) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2008-02-20 |