| NPI | 1861939357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA RALPH Office Manager 253-520-0158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MD60644231) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |