Provider First Line Business Practice Location Address:
2211 E MILL PLAIN BLVD
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE VANCOUVER MEDICAL OFFICE
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98661-9926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-992-4172
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2005