Provider First Line Business Practice Location Address:
464 12TH AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98122-5567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-322-2970
Provider Business Practice Location Address Fax Number:
206-568-8253
Provider Enumeration Date:
01/18/2007