Provider First Line Business Practice Location Address:
7100 ROOSEVELT WAY NE
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:
98115-5652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-524-7424
Provider Business Practice Location Address Fax Number:
206-526-8747
Provider Enumeration Date:
06/02/2011