Provider First Line Business Practice Location Address:
4530 UNION BAY PLACE NE
Provider Second Line Business Practice Location Address:
SUITE 214
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-420-7345
Provider Business Practice Location Address Fax Number:
206-829-9678
Provider Enumeration Date:
09/21/2011