Provider First Line Business Practice Location Address:
12303 NE 130TH LN STE 210
Provider Second Line Business Practice Location Address:
EVERGREEN HOSPITAL PROFESSIONAL CENTER PHARMACY
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034-3060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-899-2792
Provider Business Practice Location Address Fax Number:
425-899-2795
Provider Enumeration Date:
01/24/2007