| NPI | 1760936637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YONG K PARK Owner 253-839-8106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA DE00009186) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |