Provider First Line Business Practice Location Address:
12015 NE 8TH ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005-3141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-451-4465
Provider Business Practice Location Address Fax Number:
425-462-4247
Provider Enumeration Date:
03/08/2012