Provider First Line Business Practice Location Address:
1119 4TH AVE
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:
98101-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-623-4400
Provider Business Practice Location Address Fax Number:
206-623-4411
Provider Enumeration Date:
04/30/2007