| NPI | 1740425685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN M ALDRICH Owner/Physician 360-755-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WA MD00013642) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WA MD00023548) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2010-09-15 |