| NPI | 1649729385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPSHIKHA DATTA Physician 509-943-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA MD00037451) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |