Provider First Line Business Practice Location Address:
315 MARTIN LUTHER KING JR WAY
Provider Second Line Business Practice Location Address:
MS 315-C2-RX
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-4234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-403-1078
Provider Business Practice Location Address Fax Number:
253-403-1558
Provider Enumeration Date:
10/22/2015