Provider First Line Business Practice Location Address:
12535 15TH AVE NE STE 201
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:
98125-3978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-275-1238
Provider Business Practice Location Address Fax Number:
888-807-5991
Provider Enumeration Date:
11/17/2008