| NPI | 1639261258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FJ TOLLEFSON Managing Partner 360-280-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 208600000X Surgery (Licence: WA 601814468) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-11-01 |