Provider First Line Business Practice Location Address:
350 S. 333RD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEDERAL WAY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98003-6321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-830-5200
Provider Business Practice Location Address Fax Number:
253-874-5386
Provider Enumeration Date:
12/24/2008