Provider First Line Business Practice Location Address:
8245 20TH AVE NE
Provider Second Line Business Practice Location Address:
#4
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98115-4407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-524-9400
Provider Business Practice Location Address Fax Number:
206-524-9401
Provider Enumeration Date:
01/09/2007