Provider First Line Business Practice Location Address:
11033 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:
98133-8742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-368-9478
Provider Business Practice Location Address Fax Number:
206-306-9891
Provider Enumeration Date:
03/16/2007