| NPI | 1558752741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DOWNEY Practice Manager 360-613-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WA MD00037240) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2024-01-04 |