Provider First Line Business Practice Location Address:
2840 NORTHUP WAY STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-1464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-774-1538
Provider Business Practice Location Address Fax Number:
425-774-5171
Provider Enumeration Date:
12/13/2012