Provider First Line Business Practice Location Address: 
8301 161ST AVE NE STE 300
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
REDMOND
    Provider Business Practice Location Address State Name: 
WA
    Provider Business Practice Location Address Postal Code: 
98052-3858
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
425-885-3330
    Provider Business Practice Location Address Fax Number: 
425-702-2474
    Provider Enumeration Date: 
10/06/2006