Provider First Line Business Practice Location Address:
1409 5TH AVE
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:
98101-2313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-624-3590
Provider Business Practice Location Address Fax Number:
206-583-4139
Provider Enumeration Date:
12/20/2006