Provider First Line Business Practice Location Address:
3525 ENSIGN RD NE STE R
Provider Second Line Business Practice Location Address:
PMG SW WA OLYMPIA INFECTIOUS DISEASES
Provider Business Practice Location Address City Name:
OLYMPIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98506-5065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-493-4001
Provider Business Practice Location Address Fax Number:
360-438-2026
Provider Enumeration Date:
06/19/2007