| NPI | 1508169798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN JACKSON Office Manager 206-525-2813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 602301797) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2010-12-10 |