Provider First Line Business Practice Location Address:
5301 TIETON DRIVE, SUITE C
Provider Second Line Business Practice Location Address:
C/O CATHOLIC FAMILY & CHILD SERVICE
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-3478
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-7100
Provider Business Practice Location Address Fax Number:
509-966-9750
Provider Enumeration Date:
06/26/2013