Provider First Line Business Practice Location Address:
MEDICAL CENTER 400 NE
Provider Second Line Business Practice Location Address:
MOTHER JOSEPH PLACE
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98668-9989
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-514-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/24/2007