Provider First Line Business Practice Location Address:
19655 1ST AVE S STE 209
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORMANDY PARK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98148-2172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-824-3000
Provider Business Practice Location Address Fax Number:
206-824-4555
Provider Enumeration Date:
01/30/2008