| NPI | 1548466253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KUNKEL Manager 360-754-9409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: WA AP30001995) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WA AP30004521) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2009-03-17 |