| NPI | 1730201450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE STEPHEN EASTBURN President 509-747-0845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00037646) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-02-19 |