Provider First Line Business Practice Location Address:
5706 ROAD 60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASCO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99301-9597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-543-6700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2026