| NPI | 1699943993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JEAN GRAY Registered Nurse 253-583-1124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA rn00156340) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |