Provider First Line Business Practice Location Address:
200 NAT WASHINGTON WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98823-1997
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-754-4631
Provider Business Practice Location Address Fax Number:
509-754-6356
Provider Enumeration Date:
11/17/2005