| NPI | 1619188869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STELLA DESYATNIKOVA Owner 206-682-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602302730) |
| Enumeration Date | 2007-05-26 |
| Last Update Date | 2018-06-21 |