Provider First Line Business Practice Location Address:
13730 LAKE CITY 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:
98125-3692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-362-3888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2010