Provider First Line Business Practice Location Address:
1500 FAIRVIEW AVE E
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98102-3727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-325-7456
Provider Business Practice Location Address Fax Number:
206-323-6273
Provider Enumeration Date:
03/11/2010