Provider First Line Business Practice Location Address:
1314 8TH ST NE STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98002-4587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-939-2424
Provider Business Practice Location Address Fax Number:
253-931-5529
Provider Enumeration Date:
10/15/2025