Provider First Line Business Practice Location Address:
18123 E VALLEY HWY
Provider Second Line Business Practice Location Address:
SUITE B-104
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98032-1007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-656-2919
Provider Business Practice Location Address Fax Number:
425-656-7878
Provider Enumeration Date:
07/08/2010