Provider First Line Business Practice Location Address:
12015 115TH AVE NE
Provider Second Line Business Practice Location Address:
BLDG E SUITE 195
Provider Business Practice Location Address City Name:
KIRKLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98034-6940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-285-3883
Provider Business Practice Location Address Fax Number:
425-285-3887
Provider Enumeration Date:
02/08/2007