| NPI | 1912056870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT SPRAY Credentialing Manager 425-277-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WA 600461511) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-04-21 |