| NPI | 1508029844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI WALLEN Billing/Support 509-466-3960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP00001655) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2010-07-12 |