Provider First Line Business Practice Location Address:
2815 S MCCLELLAN ST
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:
98144-5407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-722-5000
Provider Business Practice Location Address Fax Number:
206-721-1428
Provider Enumeration Date:
10/04/2006