Provider First Line Business Practice Location Address:
12233 116TH AVE NE
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034-6911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-823-1583
Provider Business Practice Location Address Fax Number:
425-823-0707
Provider Enumeration Date:
10/17/2006