Provider First Line Business Practice Location Address:
6502 NE 181ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028-4802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-486-6511
Provider Business Practice Location Address Fax Number:
425-486-8915
Provider Enumeration Date:
10/10/2006