Provider First Line Business Practice Location Address:
2033 MINOR AVE EAST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98102-3500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-322-1244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006