Provider First Line Business Practice Location Address:
2409 N 45TH 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:
98103-6907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-633-8100
Provider Business Practice Location Address Fax Number:
206-633-6107
Provider Enumeration Date:
07/09/2006