Provider First Line Business Practice Location Address:
6417 PHINNEY AVE N
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:
98103-5517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-782-6463
Provider Business Practice Location Address Fax Number:
206-782-6465
Provider Enumeration Date:
03/12/2007