Provider First Line Business Practice Location Address:
4705 16TH AVE NE
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:
98105-4208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-721-1200
Provider Business Practice Location Address Fax Number:
206-527-0725
Provider Enumeration Date:
05/14/2009