Provider First Line Business Practice Location Address:
6518 PHINNEY AVE N STE A
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:
98103-5239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-745-3526
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2014