Provider First Line Business Practice Location Address:
1211 E HOWELL ST
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:
98122-2520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-322-7304
Provider Business Practice Location Address Fax Number:
206-322-8318
Provider Enumeration Date:
04/16/2007