| NPI | 1467681171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FREDERIC MELCHER Medical Manager 360-457-4431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA 50D0989250) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |