Provider First Line Business Practice Location Address:
9730 3RD AVE NE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98115-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-522-5243
Provider Business Practice Location Address Fax Number:
206-522-9628
Provider Enumeration Date:
09/07/2006