| NPI | 1548752918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN FRANCIS CIEZKI Owner/Operator 509-295-8398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA 604282863) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2022-01-19 |