Provider First Line Business Practice Location Address:
8401 GREENWOOD AVE N
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:
98103-4236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-782-1597
Provider Business Practice Location Address Fax Number:
206-902-4341
Provider Enumeration Date:
11/11/2010