Provider First Line Business Practice Location Address:
12926 SE 244TH 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:
98030-5055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-709-6150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2026