| NPI | 1891714978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY T. BENNETT Anp 360-225-7794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OR 094007013N3) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |