Provider First Line Business Practice Location Address:
1660 COLUMBIAN WAY SOUTH
Provider Second Line Business Practice Location Address:
VAPSHCS
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98108-1532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-762-1010
Provider Business Practice Location Address Fax Number:
206-764-2239
Provider Enumeration Date:
10/03/2006