Provider First Line Business Practice Location Address:
2270 NE 53RD 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:
98105-3212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-525-7170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2009