Provider First Line Business Practice Location Address:
1530 N 115TH ST STE 307
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:
98133-8419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-368-0966
Provider Business Practice Location Address Fax Number:
206-368-1669
Provider Enumeration Date:
01/08/2007