| NPI | 1871770594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA J DAVIS President/Owner 360-695-8553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA MD00043457) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-02-29 |