| NPI | 1619121654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENNAE HOLM Practice Administrator 360-459-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60046050) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |