| NPI | 1629574264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE B WOODS Officer/President 509-571-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: WA 604097030) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2018-05-24 |