| NPI | 1689919292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S OPSAHL Manager 425-822-7662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA MD00004391) |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2012-12-07 |