| NPI | 1811177975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY S GRACE President Of Corporation 253-841-4262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: WA PO 00000441) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2011-05-20 |