| NPI | 1588897102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEETTA M GRAY Sole Member 425-999-2628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD025209MD00035417) |
| Enumeration Date | 2009-08-30 |
| Last Update Date | 2015-03-23 |