Provider First Line Business Practice Location Address:
6048 26TH AVE SW
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:
98106-1440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-353-9334
Provider Business Practice Location Address Fax Number:
206-932-9912
Provider Enumeration Date:
03/17/2008