Provider First Line Business Practice Location Address: 
4800 SAND POINT WAY NE
    Provider Second Line Business Practice Location Address: 
M/S CHC
    Provider Business Practice Location Address City Name: 
SEATTLE
    Provider Business Practice Location Address State Name: 
WA
    Provider Business Practice Location Address Postal Code: 
98105-3901
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
425-482-4119
    Provider Business Practice Location Address Fax Number: 
425-482-4249
    Provider Enumeration Date: 
07/07/2008