Provider First Line Business Practice Location Address:
1723 NW MARKET 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:
98107-5225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-783-2960
Provider Business Practice Location Address Fax Number:
206-784-7522
Provider Enumeration Date:
03/12/2007