| NPI | 1487986774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MARIE STANTON Clinician 253-222-8486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WA LH60016068) |
| Additional Taxonomies | 251S00000X (Licence: WA CP60117058) |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2012-03-03 |