Provider First Line Business Practice Location Address:
118 SW 330TH ST STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEDERAL WAY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98023-6185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-874-3000
Provider Business Practice Location Address Fax Number:
253-927-1566
Provider Enumeration Date:
02/24/2007