Provider First Line Business Practice Location Address:
8606 35TH AVE NE
Provider Second Line Business Practice Location Address:
SUITE L2
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-495-8458
Provider Business Practice Location Address Fax Number:
425-353-8041
Provider Enumeration Date:
03/06/2007