| NPI | 1700216587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LOHN Executive Director 360-694-0355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA 601664816) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |