| NPI | 1497953921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLYNN L SHIDELER President 425-996-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G23099) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA md00045810) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2008-03-04 |