| NPI | 1770305898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS MERRYMAN Provider/Owner 206-595-2138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2024-10-29 |
| Last Update Date | 2024-10-29 |