Provider First Line Business Practice Location Address:
12715 BEL-RED RD.
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005-2627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-453-1117
Provider Business Practice Location Address Fax Number:
425-462-1878
Provider Enumeration Date:
11/14/2006