| NPI | 1720023823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA CORONEL Compliance Officer 206-368-1738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA MD21915) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2020-08-22 |