| NPI | 1518034180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GAIL MCKAY Practice Manager 360-736-6778 |
| Organization Subpart ? | |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD00029916) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00038226) |
| 208000000X Pediatrics (Licence: WA MD00028578) | |
| 208000000X Pediatrics (Licence: WA MD00027525) | |
| 208000000X Pediatrics (Licence: WA MD00032554) | |
| 208000000X Pediatrics (Licence: WA MD00043677) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: WA MD00039351) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP30006273) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP30007039) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP60086265) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-06-11 |