Provider First Line Business Practice Location Address:
22840 NE 8TH ST
Provider Second Line Business Practice Location Address:
SUITE #103
Provider Business Practice Location Address City Name:
SAMMAMISH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98074-7262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-898-1228
Provider Business Practice Location Address Fax Number:
425-898-0279
Provider Enumeration Date:
12/12/2007