Provider First Line Business Practice Location Address:
11 80 8 NORTHUP WAY W-300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-284-1548
Provider Business Practice Location Address Fax Number:
425-254-1546
Provider Enumeration Date:
05/22/2006