| NPI | 1750754883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMON KOONER President 425-577-1517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10004437) |
| Enumeration Date | 2015-11-11 |
| Last Update Date | 2015-11-11 |