| NPI | 1770756090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY A CLANCY Owner 206-508-1265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: WA OT00001887) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2009-07-13 |