Provider First Line Business Practice Location Address:
1402 3RD AVE
Provider Second Line Business Practice Location Address:
STE. 624
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98101-2195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-447-7217
Provider Business Practice Location Address Fax Number:
206-447-7001
Provider Enumeration Date:
08/31/2006