Provider First Line Business Practice Location Address:
6939 COAL CREEK PKWY SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWCASTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98059-3136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-644-4416
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2005