Provider First Line Business Practice Location Address:
1011 NE HIGH STREET
Provider Second Line Business Practice Location Address:
SUITE #200
Provider Business Practice Location Address City Name:
ISSAQUAH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-391-7337
Provider Business Practice Location Address Fax Number:
425-391-3915
Provider Enumeration Date:
11/21/2006