Provider First Line Business Practice Location Address:
2331 46TH AVE SW
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:
98116-2416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-935-4744
Provider Business Practice Location Address Fax Number:
206-937-1516
Provider Enumeration Date:
02/17/2010