Provider First Line Business Practice Location Address:
8115 GREENWOOD AVE N
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:
98103-4230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-789-9627
Provider Business Practice Location Address Fax Number:
206-522-2990
Provider Enumeration Date:
07/25/2007