Provider First Line Business Practice Location Address:
5801 NE 180TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028-4520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-489-0718
Provider Business Practice Location Address Fax Number:
425-489-0718
Provider Enumeration Date:
01/31/2014