| NPI | 1558628891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN JOAN HENDERSON Nurse Practitioner 360-894-4702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007081) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |