Provider First Line Business Practice Location Address:
2800 SOUTH 224TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98198
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-824-0600
Provider Business Practice Location Address Fax Number:
971-206-5203
Provider Enumeration Date:
05/18/2011