| NPI | 1669927133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN KIRKPATRICK Owner 509-397-4077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA DE00005276) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |