| NPI | 1902914419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE CLONTZ President 360-705-0122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: WA LR00002535) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |