NPI | 1952583536 |
---|---|
Entity Type | Organization |
Authorized Contact | CONNIE LEE PIRANIO Doctor 360-459-3333 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA OD00003048) |
Additional Taxonomies | 305R00000X Preferred Provider Organization |
Enumeration Date | 2007-12-05 |
Last Update Date | 2015-10-27 |