Provider First Line Business Practice Location Address:
1550 N 115TH 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:
98133-8401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-368-1765
Provider Business Practice Location Address Fax Number:
206-368-1197
Provider Enumeration Date:
12/05/2006