| NPI | 1619001088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CURTISS STANLEY Administrator 360-493-4602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA 602236962) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |