| NPI | 1730859588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA STUIT Administrator 360-752-0518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2021-09-14 |