Provider First Line Business Practice Location Address:
3533 172ND STREET NE
Provider Second Line Business Practice Location Address:
BLDG B
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-658-3000
Provider Business Practice Location Address Fax Number:
360-653-1560
Provider Enumeration Date:
05/07/2007