| NPI | 1942204664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY HINTZ Administrator 360-992-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 213E00000X Podiatrist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2022-09-28 |