Provider First Line Business Practice Location Address:
2442 NW MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 237
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98107-4137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-861-3727
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2008