Provider First Line Business Practice Location Address:
8915 14TH AVE S
Provider Second Line Business Practice Location Address:
SECOND FLOOR
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98108-4813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-762-3263
Provider Business Practice Location Address Fax Number:
206-763-6574
Provider Enumeration Date:
11/01/2006