Provider First Line Business Practice Location Address:
402 E YAKIMA AVE STE 800
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:
98901-5410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-307-0972
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/16/2021