Provider First Line Business Practice Location Address:
205 BUTTE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHELAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98816-9500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-271-3039
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2026