| NPI | 1497920102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA A MARSHALL Owner 360-234-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA 602822387) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-08-04 |