Provider First Line Business Practice Location Address:
2221 NE 139TH STREET
Provider Second Line Business Practice Location Address:
LEGACY SALMON CREEK
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-213-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2008