Provider First Line Business Practice Location Address:
7800 NE BOTHELL WAY
Provider Second Line Business Practice Location Address:
#155
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-729-7429
Provider Business Practice Location Address Fax Number:
206-826-0455
Provider Enumeration Date:
12/05/2006