Provider First Line Business Practice Location Address:
10002 SE 240TH ST
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:
98031-4839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-852-2020
Provider Business Practice Location Address Fax Number:
253-854-2020
Provider Enumeration Date:
10/29/2012