Provider First Line Business Practice Location Address:
5701 NE BOTHELL WAY STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028-9400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-486-9233
Provider Business Practice Location Address Fax Number:
425-487-4394
Provider Enumeration Date:
12/14/2006