Provider First Line Business Practice Location Address:
2828 NORTHWEST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-647-8846
Provider Business Practice Location Address Fax Number:
360-647-8854
Provider Enumeration Date:
05/27/2026