Provider First Line Business Practice Location Address:
4807 196TH ST. S.W,
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-774-4269
Provider Business Practice Location Address Fax Number:
425-744-1216
Provider Enumeration Date:
10/04/2006