| NPI | 1912451352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES R MALONE Owner 360-535-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP30005187) |
| Enumeration Date | 2016-08-14 |
| Last Update Date | 2016-08-14 |