| NPI | 1710215553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZI LUNDBERG Billing Manager 509-628-2843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00044678) |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2009-12-04 |