Provider First Line Business Practice Location Address:
11821 NE 128TH ST STE B
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:
98034-7210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-814-2800
Provider Business Practice Location Address Fax Number:
425-823-0882
Provider Enumeration Date:
12/19/2014