| NPI | 1861853251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON JOEL TVETEN Doctor 509-663-4838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA de00008505) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-29 |