NPI | 1639378607 |
---|---|
Entity Type | Organization |
Authorized Contact | SHEILA MARIE MITCHELL President 360-882-7373 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00027930) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30005464) |
Enumeration Date | 2007-07-11 |
Last Update Date | 2007-10-30 |