| NPI | 1790939833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAUMYAJIT NMI DATTA Owner 509-943-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD 00037210) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2017-02-09 |