Provider First Line Business Practice Location Address:
23845 SE ISSAQUAH FALL CITY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ISSAQUAH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98029-7514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-584-6738
Provider Business Practice Location Address Fax Number:
425-654-2680
Provider Enumeration Date:
09/09/2025