| NPI | 1619373628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLEE MATHEWS Lmp 253-474-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: WA MA60519807) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |