| NPI | 1992101786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED GRIESMAN Physician 360-481-5771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WA 10481) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2014-11-06 |