Provider First Line Business Practice Location Address:
1127 FEDERAL AVE E
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:
98102-4314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-328-4093
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2013