Provider First Line Business Practice Location Address:
5350 TALLMAN AVE NW
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98107-5902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-320-3335
Provider Business Practice Location Address Fax Number:
206-320-8027
Provider Enumeration Date:
11/02/2006