Provider First Line Business Practice Location Address:
513 W WASHINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98903-1308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-895-5623
Provider Business Practice Location Address Fax Number:
509-207-7423
Provider Enumeration Date:
10/26/2020