Provider First Line Business Practice Location Address:
9706 4TH AVE NE STE 100
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:
98115-2199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-527-2987
Provider Business Practice Location Address Fax Number:
206-527-1208
Provider Enumeration Date:
01/24/2006