Provider First Line Business Practice Location Address:
8315 5TH AVE NE STE B
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:
98115-4100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-590-2300
Provider Business Practice Location Address Fax Number:
206-590-6230
Provider Enumeration Date:
08/17/2009