Provider First Line Business Practice Location Address:
126 AUBURN AVE
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98002-5057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-288-2140
Provider Business Practice Location Address Fax Number:
253-288-2219
Provider Enumeration Date:
11/19/2007