Provider First Line Business Practice Location Address:
815 S PEARL
Provider Second Line Business Practice Location Address:
PEARL STREET CENTER
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-396-5930
Provider Business Practice Location Address Fax Number:
253-566-2252
Provider Enumeration Date:
07/22/2008