Provider First Line Business Practice Location Address:
100 E. 33RD STREET
Provider Second Line Business Practice Location Address:
FAMILY MEDICINE OF SW WASHINGTON
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-514-7550
Provider Business Practice Location Address Fax Number:
360-514-7494
Provider Enumeration Date:
01/23/2006