| NPI | 1558149807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LOU LONDERVILLE Billing & Contracting Manager 425-259-1884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |