Provider First Line Business Practice Location Address:
1700 132ND ST
Provider Second Line Business Practice Location Address:
SUITE L
Provider Business Practice Location Address City Name:
MILL CREEK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-338-1555
Provider Business Practice Location Address Fax Number:
425-338-0765
Provider Enumeration Date:
09/30/2006