| NPI | 1609092964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA LEE LANMAN Assistant Office Manager 360-426-2653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 601868919) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-10-16 |