| NPI | 1669898201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE R MOREY Manager 253-272-8285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology (Licence: WA MD00031747) |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-06 |