| NPI | 1750639704 |
|---|---|
| Other Name | PEDIATRICS PM |
| Entity Type | Organization |
| Authorized Contact | SUSANNE I ROACH Office Manager 253-848-2303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60305667) |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2012-08-23 |