Provider First Line Business Practice Location Address:
1222 N 185TH ST STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHORELINE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133-4034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-953-5799
Provider Business Practice Location Address Fax Number:
206-546-2821
Provider Enumeration Date:
03/17/2026