Provider First Line Business Practice Location Address:
2150 N 107TH ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133-1305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-361-4707
Provider Business Practice Location Address Fax Number:
206-365-0926
Provider Enumeration Date:
11/22/2006