Provider First Line Business Practice Location Address:
22142 SE 237TH ST, SUITE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAPLE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98038-5510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-432-1292
Provider Business Practice Location Address Fax Number:
425-432-0192
Provider Enumeration Date:
01/02/2007