Provider First Line Business Practice Location Address:
19410 HIGHWAY 99 STE A-124
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:
98036-5102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-715-5230
Provider Business Practice Location Address Fax Number:
206-326-1160
Provider Enumeration Date:
05/16/2014