Provider First Line Business Practice Location Address:
411 W MERCER 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:
98119-3918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-281-8865
Provider Business Practice Location Address Fax Number:
206-285-4220
Provider Enumeration Date:
04/10/2007