Provider First Line Business Practice Location Address:
1959 NE PACIFIC ST.
Provider Second Line Business Practice Location Address:
ROOM NN 256
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98195-6123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-598-4000
Provider Business Practice Location Address Fax Number:
206-598-4569
Provider Enumeration Date:
07/04/2006