| NPI | 1922635887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA R OTTE Credentialing/Contracting Manager 206-387-2469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-06-29 |