Provider First Line Business Practice Location Address:
14700 NE 8TH ST
Provider Second Line Business Practice Location Address:
SUITE 115
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98007-4115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-644-8386
Provider Business Practice Location Address Fax Number:
425-644-2560
Provider Enumeration Date:
09/13/2011