Provider First Line Business Practice Location Address:
338 NW 85TH 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:
98117-3120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-659-5945
Provider Business Practice Location Address Fax Number:
206-494-4562
Provider Enumeration Date:
03/20/2018