Provider First Line Business Practice Location Address:
11629 AVONDALE RD NE
Provider Second Line Business Practice Location Address:
AVONDALE HOUSE
Provider Business Practice Location Address City Name:
REDMOND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98052-2201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-653-5080
Provider Business Practice Location Address Fax Number:
425-653-5081
Provider Enumeration Date:
01/25/2011