| NPI | 1841286101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN KASMAN Administrator 253-697-2074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602276071) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2020-08-22 |