Provider First Line Business Practice Location Address:
1990 HOSPITAL DRIVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SEDRO-WOOLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98284-9315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-856-4141
Provider Business Practice Location Address Fax Number:
360-856-4145
Provider Enumeration Date:
03/29/2006