Provider First Line Business Practice Location Address:
547 S 330TH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEDERAL WAY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98003-5900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-446-3777
Provider Business Practice Location Address Fax Number:
206-446-3777
Provider Enumeration Date:
02/20/2026