Provider First Line Business Practice Location Address:
2121 N.E. 139TH ST., SUITE 200, MEDICAL OFFICE BUILDING
Provider Second Line Business Practice Location Address:
A, LEGACY SALMON CREEK MEDICAL CENTER CAMPUS
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98686-2316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-487-1777
Provider Business Practice Location Address Fax Number:
360-487-1779
Provider Enumeration Date:
07/27/2020