| NPI | 1790936185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 282N00000X General Acute Care Hospital (Licence: WA HAC.FS.00000084) | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-10-04 |
| Last Update Date | 2025-05-07 |