| NPI | 1497929152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN THOMAS GERHARD President 360-571-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA MD00035811) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |