| NPI | 1750456273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE V ASH Administrator 360-734-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: WA 50D0699072) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2017-05-05 |