| NPI | 1548213077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA PEARSON Credentialing Specialist 360-242-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AK 246666) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QS0132X Clinic/Center, Ophthalmologic Surgery (Licence: AK 246666) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-11-18 |