Provider First Line Business Practice Location Address:
9245 RAINIER AVE S
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:
98118-5569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-722-8444
Provider Business Practice Location Address Fax Number:
206-721-6310
Provider Enumeration Date:
03/20/2013