Provider First Line Business Practice Location Address:
4515 MLK WAY
Provider Second Line Business Practice Location Address:
PROVIDENCE ELDERPLACE,
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-320-5325
Provider Business Practice Location Address Fax Number:
206-320-5326
Provider Enumeration Date:
01/11/2007