Provider First Line Business Practice Location Address:
122 16TH AVE E
Provider Second Line Business Practice Location Address:
FIRST FLOOR
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98112-5212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-302-2800
Provider Business Practice Location Address Fax Number:
206-302-2810
Provider Enumeration Date:
11/17/2015