Provider First Line Business Practice Location Address:
1007 N HARRISON CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98802-4686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-408-4764
Provider Business Practice Location Address Fax Number:
206-521-8834
Provider Enumeration Date:
10/23/2026