Provider First Line Business Practice Location Address:
12340 NE 8TH ST
Provider Second Line Business Practice Location Address:
SUITE #101
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98005-3189
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-603-1988
Provider Business Practice Location Address Fax Number:
425-451-2696
Provider Enumeration Date:
09/29/2006