Provider First Line Business Practice Location Address:
11808 NORTHUP WAY
Provider Second Line Business Practice Location Address:
W 150
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005-1936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-889-1240
Provider Business Practice Location Address Fax Number:
425-889-1249
Provider Enumeration Date:
02/03/2008