Provider First Line Business Practice Location Address:
7750 15TH AVE NE
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:
98115-4313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-729-1175
Provider Business Practice Location Address Fax Number:
206-729-1223
Provider Enumeration Date:
01/10/2006