Provider First Line Business Practice Location Address:
7126 NE 135TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034-5008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-224-7672
Provider Business Practice Location Address Fax Number:
425-439-7080
Provider Enumeration Date:
09/28/2026