Provider First Line Business Practice Location Address:
6730 NE 201ST PL STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028-8673
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-948-5619
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2007