| NPI | 1972819175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 261QH0100X Clinic/Center Health Service | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2018-01-11 |