| NPI | 1962706655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL K SIM Partner 360-946-4313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 50-C0001292) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2024-11-07 |