| NPI | 1861493272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY JOY WALLUM Owner 425-453-9762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: WA MD00024156) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2010-01-15 |