Provider First Line Business Practice Location Address:
1900 COMMERCE ST MDS-101
Provider Second Line Business Practice Location Address:
UW AUTISM CENTER - TACOMA BOX 358455
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98402-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-219-1963
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2017