Provider First Line Business Practice Location Address:
3216 NE 45TH PL STE 212
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:
98105-4028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-386-3600
Provider Business Practice Location Address Fax Number:
206-526-9159
Provider Enumeration Date:
01/31/2007