Provider First Line Business Practice Location Address:
2134 N 52ND ST
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:
98103-6218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-595-5245
Provider Business Practice Location Address Fax Number:
206-632-0990
Provider Enumeration Date:
05/03/2007