| NPI | 1962500181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL B CALDWELL President/Owner 425-454-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: WA MD00015594) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-07-07 |