Provider First Line Business Practice Location Address:
3530 SUNNYSIDE MABTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYSIDE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98944-9732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-502-8135
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2026