Provider First Line Business Practice Location Address:
7217 NE 160TH 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:
98028-4256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-296-0774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/31/2021