Provider First Line Business Practice Location Address:
VA PUGET SOUND HCS
Provider Second Line Business Practice Location Address:
AMERICAN LAKE DIVISION
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98493-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-329-8387
Provider Business Practice Location Address Fax Number:
253-589-4167
Provider Enumeration Date:
08/31/2006