| NPI | 1548641616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BELCASTER Owner 360-920-4328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA AP60112444) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |