Provider First Line Business Practice Location Address:
12600 SE 38TH ST
Provider Second Line Business Practice Location Address:
SUITE 235
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98006-5232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-890-8988
Provider Business Practice Location Address Fax Number:
425-637-1150
Provider Enumeration Date:
11/03/2006