| NPI | 1912198748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN J GEIGLE Practice Manager 360-449-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA 601650251) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |