Provider First Line Business Practice Location Address:
309 FEDERAL AVE E
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98102-5416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-324-8285
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2005