| NPI | 1508645235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE BOWDEN Contracting & Credentialing Manager 509-570-9302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2025-04-15 |