Provider First Line Business Practice Location Address:
20000 NE 154TH ST
Provider Second Line Business Practice Location Address:
HOCKINSON SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
BRUSH PRAIRIE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-448-6499
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2013