Provider First Line Business Practice Location Address:
2240 E LINCOLN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYSIDE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98944-2487
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-400-4700
Provider Business Practice Location Address Fax Number:
509-213-2819
Provider Enumeration Date:
01/12/2023