| NPI | 1952436339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASMA A WEBER Owner 360-582-1176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA 602172797) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2014-08-28 |