Provider First Line Business Practice Location Address:
18904 HIGHWAY 99 STE K
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98036-5219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-801-3894
Provider Business Practice Location Address Fax Number:
206-902-1325
Provider Enumeration Date:
04/03/2019