Provider First Line Business Practice Location Address:
6000 17TH AVE SW
Provider Second Line Business Practice Location Address:
APT 1
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98106-3524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-390-5855
Provider Business Practice Location Address Fax Number:
206-283-5777
Provider Enumeration Date:
05/15/2007