| NPI | 1629329636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE RENAE BARTLETT Administrator 360-899-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |