Provider First Line Business Practice Location Address:
11104 N.E. 149TH STREET
Provider Second Line Business Practice Location Address:
BATTLEGROUND SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
BRUSH PRAIRIE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-885-5300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2014