| NPI | 1518166040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE RIZARRI SON Physician 360-528-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA MD00041776) |
| Enumeration Date | 2007-07-14 |
| Last Update Date | 2011-05-10 |