Provider First Line Business Practice Location Address:
8032 35TH AVE NE
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:
98115-4815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-523-6676
Provider Business Practice Location Address Fax Number:
206-523-7900
Provider Enumeration Date:
02/28/2007