Provider First Line Business Practice Location Address:
302 N 3RD ST STE 203
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:
98901-2366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-316-2558
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/20/2026