Provider First Line Business Practice Location Address:
7500 212TH ST SW
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
EDMONDS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-775-4437
Provider Business Practice Location Address Fax Number:
425-771-2554
Provider Enumeration Date:
03/08/2006