Provider First Line Business Practice Location Address:
10322 NE 132ND ST
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:
425-823-3116
Provider Business Practice Location Address Fax Number:
425-823-3132
Provider Enumeration Date:
11/16/2006