| NPI | 1508188632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC HOUGARD JENSEN Sole Proprietor 206-542-2149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA MD00008566) |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-16 |