Provider First Line Business Practice Location Address:
1100 ELLIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-5238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-734-6190
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2026