| NPI | 1659559409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTOSA HO Owner 360-659-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA 602329907) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2014-12-08 |