Provider First Line Business Practice Location Address:
9635 DES MOINES MEMORIAL DR
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:
98108-5061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-474-2001
Provider Business Practice Location Address Fax Number:
206-764-8005
Provider Enumeration Date:
02/04/2019