Provider First Line Business Practice Location Address:
6161 NE 175TH ST
Provider Second Line Business Practice Location Address:
STE 203
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028-4800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-482-2453
Provider Business Practice Location Address Fax Number:
425-482-2452
Provider Enumeration Date:
03/01/2007