| NPI | 1528060902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL KOMOROUS President Of Corporation/Physician 253-752-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2022-07-21 |