Provider First Line Business Practice Location Address:
10101 NE 120TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034-6622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-823-2323
Provider Business Practice Location Address Fax Number:
425-821-2892
Provider Enumeration Date:
05/18/2006