| NPI | 1750465365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDI R VAIL-LUSH Manager/Corporate Secretary 360-942-4562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA op00000626) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2008-04-22 |