Provider First Line Business Practice Location Address:
32118 32ND AVE SW
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:
98023-2206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-322-7676
Provider Business Practice Location Address Fax Number:
206-726-7585
Provider Enumeration Date:
04/06/2012