Provider First Line Business Practice Location Address:
332 NE NORTHGATE WAY
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:
98125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-528-6000
Provider Business Practice Location Address Fax Number:
206-528-0014
Provider Enumeration Date:
07/21/2005