Provider First Line Business Practice Location Address:
12040 NE 128TH ST
Provider Second Line Business Practice Location Address:
EVERGREEN HOSPITAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-899-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/05/2006