Provider First Line Business Practice Location Address:
6007 244TH ST SW STE A2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTLAKE TERRACE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98043-5427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-356-3276
Provider Business Practice Location Address Fax Number:
425-356-3101
Provider Enumeration Date:
08/29/2019