| NPI | 1881084317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALDENCIA LANIECE GOSSING Manager 253-444-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP60475878) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |