Provider First Line Business Practice Location Address:
4301 N KENNEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OTIS ORCHARDS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-661-5991
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2025