Provider First Line Business Practice Location Address:
11919 NE 128TH ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034-7204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-899-5600
Provider Business Practice Location Address Fax Number:
425-899-5603
Provider Enumeration Date:
10/17/2006