Provider First Line Business Practice Location Address:
38700 SE RIVER STREET
Provider Second Line Business Practice Location Address:
SNOQUALMIE VALLEY CLINIC
Provider Business Practice Location Address City Name:
SNOQUALMIE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-888-2299
Provider Business Practice Location Address Fax Number:
425-888-1204
Provider Enumeration Date:
07/08/2006