| NPI | 1811004757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL L ROSS Physician 509-921-7884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: WA OP00001816) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2014-05-02 |