Provider First Line Business Practice Location Address:
4700 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:
98103-6374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-632-7400
Provider Business Practice Location Address Fax Number:
206-633-0589
Provider Enumeration Date:
06/15/2005