| NPI | 1790077345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN M OKITA Owner 360-359-7013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI AP30007796) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2011-05-13 |