| NPI | 1487700407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS ROBERT CARR Owner 360-943-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA OD00001152) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-07-22 |