Provider First Line Business Practice Location Address:
1215 SENECA ST
Provider Second Line Business Practice Location Address:
207
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98101-2898
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-724-5580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/10/2009