Provider First Line Business Practice Location Address:
18833 28TH AVE W.
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-774-1285
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2008