Provider First Line Business Practice Location Address:
2442 NW MARKET
Provider Second Line Business Practice Location Address:
#317
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-335-2892
Provider Business Practice Location Address Fax Number:
206-789-6583
Provider Enumeration Date:
07/11/2006