Provider First Line Business Practice Location Address:
6850 35TH AVENUE NE
Provider Second Line Business Practice Location Address:
SUITE 9
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98115-7344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-527-8998
Provider Business Practice Location Address Fax Number:
206-527-8996
Provider Enumeration Date:
10/04/2006