Provider First Line Business Practice Location Address:
3013 S MOUNT BAKER BLVD
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:
98144-6139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-941-4874
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2009