| NPI | 1467752659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA MARCELO DE LOS REYES Manager 509-582-3571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 602094837) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |