NPI | 1528599685 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY NEAL ZOLA Medical Director 360-742-3562 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: WA MD60017650) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2017-03-21 |
Last Update Date | 2017-03-21 |