| NPI | 1770127722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MATHEW Managing Member 360-775-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2020-01-10 |