| NPI | 1801261847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABAH TARGHI Owner 360-258-0627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: WA NT60548368) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2015-12-02 |