Provider First Line Business Practice Location Address:
836B NW 52ND 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:
98107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-264-9400
Provider Business Practice Location Address Fax Number:
206-264-4939
Provider Enumeration Date:
12/18/2009