| NPI | 1588765739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD N WITTE Managing Member 360-734-1420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 601886708) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2023-05-24 |