| NPI | 1811377484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI DVORAK Owner 425-923-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA MA00020416) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2015-06-09 |