| NPI | 1720571607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANYA ELLER Licensing Analyst & Legal Asst 206-395-7870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2026-01-16 |