| NPI | 1841493194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA CASTRO FERNANDEZ KIEMELE Owner 253-857-9348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 39111) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |