| NPI | 1467751628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH RICHARDSON Director And Provider 360-312-4342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30006923) |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2011-03-26 |