Provider First Line Business Practice Location Address:
3002 NW MARKET STREET
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:
98107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-380-6445
Provider Business Practice Location Address Fax Number:
206-522-5484
Provider Enumeration Date:
09/14/2006