Provider First Line Business Practice Location Address:
3217 41ST AVE SW
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:
98116-3444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-937-1460
Provider Business Practice Location Address Fax Number:
206-938-1990
Provider Enumeration Date:
05/20/2006