Provider First Line Business Practice Location Address:
12816 SE 38TH ST STE I
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:
98006-1327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-747-7650
Provider Business Practice Location Address Fax Number:
425-653-1502
Provider Enumeration Date:
06/26/2008