Provider First Line Business Practice Location Address:
140 SW 146TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURIEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98166-1912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-901-2400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2014