| NPI | 1578035200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MOON Contracting COO Rdinator 206-538-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2023-02-09 |