| NPI | 1699523100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAIRE LAH Credentialing Manager 360-471-0628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-05-11 |