| NPI | 1861624876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN FREY Practice Administrator 360-377-3923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| 207RR0500X Internal Medicine, Rheumatology | |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2009-11-12 |