Provider First Line Business Practice Location Address:
10830 SE KENT KANGLEY RD STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98030-9011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-854-3040
Provider Business Practice Location Address Fax Number:
253-854-3821
Provider Enumeration Date:
07/08/2009