Provider First Line Business Practice Location Address:
2700 EVERGREEN PARKWAY NW, SEM 1, ROOM 2110
Provider Second Line Business Practice Location Address:
THE EVERGREEN SATE COLLEGE STUDENT HEALTH CENTER
Provider Business Practice Location Address City Name:
OLYMPIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-867-6200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2010