| NPI | 1851574750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary For Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2025-05-15 |