| NPI | 1508820556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E SPENCER Owner/Physician 360-435-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA 601345794) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-08-22 |