| NPI | 1679562201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA FALL Manager 253-682-6040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2025-03-07 |