Provider First Line Business Practice Location Address:
11320 ROOSEVELT WAY NE
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:
98125-6228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-569-4449
Provider Business Practice Location Address Fax Number:
206-363-9639
Provider Enumeration Date:
07/03/2008