Provider First Line Business Practice Location Address:
14602 NE 4TH PLAIN
Provider Second Line Business Practice Location Address:
SUITE K
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98682-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-256-0200
Provider Business Practice Location Address Fax Number:
360-256-0300
Provider Enumeration Date:
05/03/2006