Provider First Line Business Practice Location Address:
6242 WOODLAWN 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:
98103-5717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-235-7595
Provider Business Practice Location Address Fax Number:
206-365-5569
Provider Enumeration Date:
04/24/2008