Provider First Line Business Practice Location Address:
6602 S ALASKA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98408-1323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-289-5050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/17/2025