Provider First Line Business Practice Location Address:
3922 148TH ST SE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MILL CREEK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-337-7300
Provider Business Practice Location Address Fax Number:
425-337-7344
Provider Enumeration Date:
12/29/2006