Provider First Line Business Practice Location Address:
13003 SE KENT KANGLEY
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-638-2424
Provider Business Practice Location Address Fax Number:
253-639-5115
Provider Enumeration Date:
10/06/2006