Provider First Line Business Practice Location Address:
2137 S 65TH AVE UNIT 2
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:
98903-9286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-289-2100
Provider Business Practice Location Address Fax Number:
509-494-8489
Provider Enumeration Date:
07/16/2026