Provider First Line Business Practice Location Address:
3601 W WASHINGTON AVE STE 150
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:
98903-1173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-504-3478
Provider Business Practice Location Address Fax Number:
509-254-5024
Provider Enumeration Date:
05/09/2018