| NPI | 1932652823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY E FITZTHUM Owner/Provider 425-967-6974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: WA MD 00038676) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |