Provider First Line Business Practice Location Address:
3480 S 152ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUKWILA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98188-2142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-244-5216
Provider Business Practice Location Address Fax Number:
206-244-0897
Provider Enumeration Date:
03/12/2008