Provider First Line Business Practice Location Address:
1700 NW 56TH ST
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:
98026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-783-0400
Provider Business Practice Location Address Fax Number:
206-783-1929
Provider Enumeration Date:
11/20/2006