| NPI | 1588631287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L BROWN Medical Director 360-336-2178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| 207Y00000X Otolaryngology | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| 2086X0206X Surgery, Surgical Oncology | |
| 208200000X Plastic Surgery | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck | |
| 208600000X Surgery | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2007-10-04 |