Provider First Line Business Practice Location Address:
7136 MLK JR WAY S
Provider Second Line Business Practice Location Address:
STE 204
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98118-3526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-362-3344
Provider Business Practice Location Address Fax Number:
206-362-3444
Provider Enumeration Date:
05/03/2007