Provider First Line Business Practice Location Address:
2811 S 102ND ST
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98168-1870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-320-4000
Provider Business Practice Location Address Fax Number:
206-320-2280
Provider Enumeration Date:
10/28/2008