| NPI | 1881755106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRIET FOLLMAN Owner And Administrator 360-755-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA 060150000) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |