Provider First Line Business Practice Location Address:
VAPSHCS ( A-112-POD )
Provider Second Line Business Practice Location Address:
6900 VETERANS DR. , SW
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98493-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-582-8440
Provider Business Practice Location Address Fax Number:
253-583-1199
Provider Enumeration Date:
06/26/2006