Provider First Line Business Practice Location Address:
32240 NE 50TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARNATION
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98014-6332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-844-4516
Provider Business Practice Location Address Fax Number:
425-844-4521
Provider Enumeration Date:
07/30/2006