Provider First Line Business Practice Location Address:
3720 CALIFORNIA AVE SW
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:
98116-3754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-938-1113
Provider Business Practice Location Address Fax Number:
206-937-7395
Provider Enumeration Date:
10/03/2006