| NPI | 1972352243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA BOSCHMA Is Director 206-461-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-07-15 |