| NPI | 1720874514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGDALENE COLEMAN Authorized Official 360-519-6953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-04-17 |