Provider First Line Business Practice Location Address:
6869 WOODLAWN AVE NE
Provider Second Line Business Practice Location Address:
STE 208
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98115-5469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-535-8867
Provider Business Practice Location Address Fax Number:
206-457-8208
Provider Enumeration Date:
04/18/2013