Provider First Line Business Practice Location Address:
19324 40TH AVE W.
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-658-2400
Provider Business Practice Location Address Fax Number:
425-526-5550
Provider Enumeration Date:
11/20/2006