| NPI | 1831253426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD KENNETH GREEN Physician And Owner 360-574-7622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2022-12-29 |