Provider First Line Business Practice Location Address:
124 E EDGAR ST
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:
98102-3132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-323-3243
Provider Business Practice Location Address Fax Number:
206-407-3243
Provider Enumeration Date:
05/12/2010