| NPI | 1689027328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN RAE WHITE Owner 360-637-9522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: WA MD60082203) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |