Provider First Line Business Practice Location Address:
16400 SOUTHCENTER PKWY
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
TUKWILA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98188-3335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-575-0400
Provider Business Practice Location Address Fax Number:
206-575-6469
Provider Enumeration Date:
11/16/2006