Provider First Line Business Practice Location Address:
7800 N E BOTHELL WAY
Provider Second Line Business Practice Location Address:
SUITE 155 B
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-488-5496
Provider Business Practice Location Address Fax Number:
425-952-9275
Provider Enumeration Date:
09/23/2008