Provider First Line Business Practice Location Address:
4204 AUBURN WAY N
Provider Second Line Business Practice Location Address:
SUITE #8
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98002-1379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-939-2243
Provider Business Practice Location Address Fax Number:
253-859-4981
Provider Enumeration Date:
04/18/2008