| NPI | 1629259437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFFAN R. TOLLES Physician 360-662-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00022023) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2021-05-06 |