Provider First Line Business Practice Location Address:
10024 SE 240TH
Provider Second Line Business Practice Location Address:
SUITE 116 JAMES STREET BUILDING
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:
253-852-2250
Provider Business Practice Location Address Fax Number:
253-850-2856
Provider Enumeration Date:
01/22/2007