| NPI | 1851532659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE M HAYES Pediatric Nurse Practitioner 253-565-7686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: WA AP30003701) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: WA RN00093723) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2009-03-09 |