Provider First Line Business Practice Location Address:
3522 199TH PL SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98036-9109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-434-2239
Provider Business Practice Location Address Fax Number:
425-582-2225
Provider Enumeration Date:
05/05/2026