| NPI | 1568640324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SCOTT PETETT Owner 425-277-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA 601459645) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-06-10 |