Provider First Line Business Practice Location Address:
1550 NORTH 115TH STREET
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:
98133-9733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-364-0500
Provider Business Practice Location Address Fax Number:
206-368-3029
Provider Enumeration Date:
08/09/2006