| NPI | 1780851477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTY D DUBOIS Member 425-485-1413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WA 3632) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2009-08-24 |