Provider First Line Business Practice Location Address:
2743 CALIFORNIA AVE SW
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-938-9380
Provider Business Practice Location Address Fax Number:
206-938-9384
Provider Enumeration Date:
10/03/2006