Provider First Line Business Practice Location Address:
1906 FEDERAL AVE EAST
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:
98102-4239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-320-9100
Provider Business Practice Location Address Fax Number:
206-320-9099
Provider Enumeration Date:
10/02/2006