| NPI | 1699119123 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CAROLYNN HOSEY Registered Nurse 509-865-2102 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA RN60065570) | 
| Enumeration Date | 2013-04-26 | 
| Last Update Date | 2013-04-26 |