Provider First Line Business Practice Location Address:
4235 S 248TH ST
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:
98032-1504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-627-5155
Provider Business Practice Location Address Fax Number:
206-237-8571
Provider Enumeration Date:
09/10/2025