Provider First Line Business Practice Location Address:
1216 S 40TH AVE
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:
98908-6023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-432-5384
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/19/2024