Provider First Line Business Practice Location Address:
1106 WASHINGTON ST
Provider Second Line Business Practice Location Address:
PE CLASSROOM BUILDING 200
Provider Business Practice Location Address City Name:
CHENEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-359-6409
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2021