Provider First Line Business Practice Location Address:
9000 RAINIER AVE S STE C
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:
98118-5017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-760-1076
Provider Business Practice Location Address Fax Number:
206-760-2655
Provider Enumeration Date:
10/30/2008