Provider First Line Business Practice Location Address:
10740 MERIDIAN AVE N
Provider Second Line Business Practice Location Address:
STE 203
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-439-2595
Provider Business Practice Location Address Fax Number:
206-439-2297
Provider Enumeration Date:
02/06/2007