Provider First Line Business Practice Location Address:
5704 E LAKE SAMMAMISH PKWY SE
Provider Second Line Business Practice Location Address:
STE #101
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:
425-270-3323
Provider Business Practice Location Address Fax Number:
425-270-3326
Provider Enumeration Date:
07/12/2011