Provider First Line Business Practice Location Address:
6701 52ND AVE S
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:
98118-3403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-745-4933
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2006