| NPI | 1851573018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANNE DUDLEY Office Manager 360-876-9158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00012489) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |