Provider First Line Business Practice Location Address:
1404 3RD AVE
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:
98101-2106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-624-1401
Provider Business Practice Location Address Fax Number:
206-624-3508
Provider Enumeration Date:
12/02/2005