Provider First Line Business Practice Location Address:
3040 NE 127TH ST
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:
98125-4415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-362-7572
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2005