Provider First Line Business Practice Location Address:
18600-B 33RD AVENUE WEST
Provider Second Line Business Practice Location Address:
ALDERWOOD PLAZA SHOPPING CENTER
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98037-4715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-771-9427
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2006