Provider First Line Business Practice Location Address:
126 NW CANAL ST STE 200126NW
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:
98107-4970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-486-8150
Provider Business Practice Location Address Fax Number:
206-775-7215
Provider Enumeration Date:
06/15/2006