Organization
KSR HEALTH CARE LLC
Active
Other names
Invara Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SIMEON ROTH PHARMD (CEO)
(360) 953-5250
Entity
Organization
Contact information
Practice address
31111 US-2, SULTAN, WA 98294
(360) 953-5250
Mailing address
PO BOX 90, SULTAN, WA 98294-0090
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2132773
—
WA
Enumeration date
08/17/2021
Last updated
03/02/2022
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