Provider First Line Business Practice Location Address:
6610 NE 181ST ST STE 4
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-892-8054
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2013