Provider First Line Business Practice Location Address:
1990 HOSPITAL DR.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SEDRO WOOLLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-856-4222
Provider Business Practice Location Address Fax Number:
360-854-2792
Provider Enumeration Date:
05/14/2007