Provider First Line Business Practice Location Address:
2001 WEST FIFTH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRANDVIEW
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
89830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-882-4400
Provider Business Practice Location Address Fax Number:
509-882-4485
Provider Enumeration Date:
03/22/2007