Provider First Line Business Practice Location Address:
11315 BRIDGEPORT WAY SW
Provider Second Line Business Practice Location Address:
EMERGENCY DEPT
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98499-3004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-985-8700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2009