Provider First Line Business Practice Location Address:
14216 NE 21ST ST
Provider Second Line Business Practice Location Address:
NORTH CREEK- WRAP
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98007-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-653-4900
Provider Business Practice Location Address Fax Number:
425-653-4910
Provider Enumeration Date:
09/17/2013