Provider First Line Business Practice Location Address:
12308 NE 144TH STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-821-9191
Provider Business Practice Location Address Fax Number:
425-825-7456
Provider Enumeration Date:
10/03/2006