Provider First Line Business Practice Location Address:
8725 SOUTH 212TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-658-3016
Provider Business Practice Location Address Fax Number:
425-658-3017
Provider Enumeration Date:
09/24/2025