NPI | 1760529374 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROL DAVIS Clinic Manager 360-566-9355 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
208000000X Pediatrics | |
Enumeration Date | 2007-01-31 |
Last Update Date | 2014-07-23 |