Provider First Line Business Practice Location Address:
34709 NINTH AVE SOUTH
Provider Second Line Business Practice Location Address:
SUITE B500
Provider Business Practice Location Address City Name:
FEDERAL WAY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-835-8800
Provider Business Practice Location Address Fax Number:
253-835-8828
Provider Enumeration Date:
06/16/2011