| NPI | 1477097251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA DEE GRAY Owner 360-892-0096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA 601876770) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |