Provider First Line Business Practice Location Address:
609 NORTHSHORE DRIVE
Provider Second Line Business Practice Location Address:
LAKE WHATCOM RESIDENTIAL AND TREATMENT CENTER
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98226-6004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-676-6000
Provider Business Practice Location Address Fax Number:
360-676-2551
Provider Enumeration Date:
01/22/2007