| NPI | 1720023641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary For Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2025-07-08 |