| NPI | 1982871950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET M LASON Practice Manager 253-756-0933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WA 602804600) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-09 |