Provider First Line Business Practice Location Address:
5150 S ORCAS ST
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:
98118-2561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-580-3160
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/02/2010