Provider First Line Business Practice Location Address:
509 OLIVE WAY,
Provider Second Line Business Practice Location Address:
SUITE 1607 QLIANCE MEDICAL GROUP OF WASHINGTON PC
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-913-4700
Provider Business Practice Location Address Fax Number:
206-913-4710
Provider Enumeration Date:
10/14/2009