Provider First Line Business Practice Location Address:
1416 NW 46TH ST, SUITE 105 # 222
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:
98107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-353-1150
Provider Business Practice Location Address Fax Number:
206-632-2248
Provider Enumeration Date:
08/03/2006