| NPI | 1659934982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL DOUGLAS KELLY Dm Sc Pac 206-418-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2024-01-30 |