NPI | 1962736991 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA TUCKER PIERCE President 360-537-6496 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60074635) |
Enumeration Date | 2009-09-23 |
Last Update Date | 2009-09-23 |