Provider First Line Business Practice Location Address:
501 S 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-3550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-573-6216
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2025