Provider First Line Business Practice Location Address:
818 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:
98108-2628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-617-9212
Provider Business Practice Location Address Fax Number:
206-763-0285
Provider Enumeration Date:
11/06/2009