Provider First Line Business Practice Location Address:
13624 HIGHWAY 99 STE B3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98087-1656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-207-5757
Provider Business Practice Location Address Fax Number:
425-207-5757
Provider Enumeration Date:
02/09/2026