| NPI | 1770645574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WILLIAMS Healthcare Business Office Director 360-312-2285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207N00000X Dermatology | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-11-13 |