Provider First Line Business Practice Location Address:
80 N TRIBAL CENTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SKOKOMISH NATION
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98584-9748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-426-7788
Provider Business Practice Location Address Fax Number:
360-877-2035
Provider Enumeration Date:
02/14/2012