| NPI | 1992706097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA FALL Manager 253-682-6040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2026-07-22 |