Provider First Line Business Practice Location Address:
400 E UNIVERSITY WAY # 40
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-7500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-346-8542
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2026