Provider First Line Business Practice Location Address:
8014 35TH AVE NE
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:
98115-4815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-313-8864
Provider Business Practice Location Address Fax Number:
206-525-4469
Provider Enumeration Date:
12/14/2006