| NPI | 1578169298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY WILLIAMS Manager, Provider Data & Enrollment 253-459-8009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2022-03-23 |