| NPI | 1649782681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A ILLER Member/Owner 206-268-0397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA NT60115399) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2017-10-31 |