Provider First Line Business Practice Location Address:
1730 MINOR AVE
Provider Second Line Business Practice Location Address:
SUITE 1140
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98101-1498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-624-2935
Provider Business Practice Location Address Fax Number:
206-325-1431
Provider Enumeration Date:
04/19/2007