| NPI | 1477931947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM KILGUS Pharmacy Manager 253-826-8433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: WA IR60290101) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-05-15 |