Provider First Line Business Practice Location Address:
1718 NE 70TH 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:
98115-5749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-527-4938
Provider Business Practice Location Address Fax Number:
206-774-0733
Provider Enumeration Date:
05/02/2007