Provider First Line Business Practice Location Address:
1201 N 44TH ST
Provider Second Line Business Practice Location Address:
APT 2
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103-7440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-239-6772
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2008