| NPI | 1518153378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE C. PALMER Owner/Manager 360-540-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA MA00024680) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2015-11-18 |