Provider First Line Business Practice Location Address:
1409 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:
98117-4237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-781-2206
Provider Business Practice Location Address Fax Number:
206-783-3949
Provider Enumeration Date:
03/08/2016