Provider First Line Business Practice Location Address:
1404 E YESLER WAY STE A
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:
98122-5516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-302-7220
Provider Business Practice Location Address Fax Number:
206-302-7221
Provider Enumeration Date:
07/25/2006