Provider First Line Business Practice Location Address:
22833 BOTHELL EVERETT HIGHWAY
Provider Second Line Business Practice Location Address:
C/O DERMSERVICE, SUITE 201
Provider Business Practice Location Address City Name:
BOTHELL
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-486-2340
Provider Business Practice Location Address Fax Number:
425-483-8135
Provider Enumeration Date:
07/09/2006