Provider First Line Business Practice Location Address:
720 N 35TH ST
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-523-0225
Provider Business Practice Location Address Fax Number:
206-760-2702
Provider Enumeration Date:
06/21/2006