Provider First Line Business Practice Location Address:
7440 W MARGINAL WAY 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:
98108-4141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-768-1990
Provider Business Practice Location Address Fax Number:
206-768-8910
Provider Enumeration Date:
05/17/2007