| NPI | 1730545070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA DERIE Manager 360-299-2781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: WA 00008657) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |