| NPI | 1669939625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN RACHELLE DESAUTEL Owner 206-313-2811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 163WX0800X Registered Nurse, Orthopedic |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine | |
| 207Q00000X Family Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2020-07-14 |