| NPI | 1922542323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS JANE TEIXEIRA Office Manager 253-946-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MD00023760) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2018-03-19 |