| NPI | 1629194550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP A MEDINA President 425-226-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD00028329) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |