Provider First Line Business Practice Location Address:
3272 CALIFORNIA AVE SW
Provider Second Line Business Practice Location Address:
#105
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98116-3375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-420-6146
Provider Business Practice Location Address Fax Number:
855-287-0185
Provider Enumeration Date:
03/13/2007