Provider First Line Business Practice Location Address:
500 S 336TH ST STE 213
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEDERAL WAY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98003-6478
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-995-0727
Provider Business Practice Location Address Fax Number:
206-325-5020
Provider Enumeration Date:
04/18/2007