| NPI | 1528814647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA PEARSON Credentialing Specialist 360-242-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |