Provider First Line Business Practice Location Address:
3100 NORTHUP WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-1467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-598-6059
Provider Business Practice Location Address Fax Number:
206-598-6075
Provider Enumeration Date:
12/20/2013