| NPI | 1619176799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF J BISHOP Account Manager 208-683-2928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00023004) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2008-04-11 |