Provider First Line Business Practice Location Address:
205 E JAMES ST
Provider Second Line Business Practice Location Address:
SUITE # 100
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98032-4555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-579-5007
Provider Business Practice Location Address Fax Number:
253-631-2090
Provider Enumeration Date:
03/01/2007