| NPI | 1811932791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY CHARLES RUDD Medical Director 360-456-7077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 261QA1903X) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |