Provider First Line Business Practice Location Address:
6601 220TH ST SW STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTLAKE TERRACE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98043-2166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-775-7274
Provider Business Practice Location Address Fax Number:
425-775-0963
Provider Enumeration Date:
01/21/2022