Provider First Line Business Mailing Address: 
MADIGAN ARMY MEDICAL CTR
    Provider Second Line Business Mailing Address: 
9040 JACKSON AVE, ATTN: MCHJ-CLQ-C
    Provider Business Mailing Address City Name: 
TACOMA
    Provider Business Mailing Address State Name: 
WA
    Provider Business Mailing Address Postal Code: 
98431-1100
    Provider Business Mailing Address Country Code: 
US
    Provider Business Mailing Address Telephone Number: 
    Provider Business Mailing Address Fax Number: