| NPI | 1750311783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA SCHUMACHER Pro Fee Credentialing Manager 360-658-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2010-03-11 |