Provider First Line Business Practice Location Address:
11349 5TH AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98146-2209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-923-6354
Provider Business Practice Location Address Fax Number:
425-374-4337
Provider Enumeration Date:
05/06/2008