Provider First Line Business Practice Location Address:
9730 3RD AVE NE STE 201
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:
98115-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-367-1345
Provider Business Practice Location Address Fax Number:
206-367-1366
Provider Enumeration Date:
09/21/2010