Provider First Line Business Practice Location Address:
A- 122- SOCIAL WORK 9600 VETERANS DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98493-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-225-9029
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2019