| NPI | 1801912241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE M MIZEN Medical Director 360-299-2650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WA 602557097) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-10-10 |