| NPI | 1902228448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORY D. JOHNSON CEO 360-421-5953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AZ C000947) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2014-01-17 |