| NPI | 1588749758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY CODD Clinic Manager 360-299-5618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-02-21 |