| NPI | 1871625970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES GREGORY Manager 360-734-2131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30003674) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP30003674) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |