| NPI | 1790846509 |
|---|---|
| Former Legal Business Name | ROBERT O MODARELLI MD PS |
| Entity Type | Organization |
| Authorized Contact | ALIA D MODARELLI Office Administrator 253-272-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA 600350465) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-31 |