Provider First Line Business Practice Location Address:
6850 35TH AVE NE STE 1
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:
98115-7344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-528-4678
Provider Business Practice Location Address Fax Number:
206-528-4678
Provider Enumeration Date:
02/13/2007