| NPI | 1699701987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA SCHUMACHER Pro Fee Credentialing Manager 360-794-7994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2010-03-11 |