| NPI | 1558718684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN NOEL PADILLA RUIZ President 253-474-5141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00024942) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |