Provider First Line Business Practice Location Address:
1800 SW 152ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURIEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98166-1700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-248-1339
Provider Business Practice Location Address Fax Number:
206-246-2711
Provider Enumeration Date:
12/08/2006