Provider First Line Business Practice Location Address:
15811 AMBAUM BLVD SW STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURIEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98166-3071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-647-0070
Provider Business Practice Location Address Fax Number:
206-629-6470
Provider Enumeration Date:
10/31/2024