Provider First Line Business Practice Location Address:
1050 140TH AVE NE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005-2972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-746-7410
Provider Business Practice Location Address Fax Number:
425-641-3520
Provider Enumeration Date:
07/25/2006