| NPI | 1639287188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY A STRANDBERG Office Administrator 360-425-6117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA 600024847) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2011-01-13 |