Provider First Line Business Practice Location Address: 
1101 MADISON ST STE 1150
    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: 
98104-3558
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
206-386-3400
    Provider Business Practice Location Address Fax Number: 
206-386-3411
    Provider Enumeration Date: 
07/10/2008