Provider First Line Business Practice Location Address:
701 N 36TH ST
Provider Second Line Business Practice Location Address:
SUITE 330
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-218-2610
Provider Business Practice Location Address Fax Number:
206-632-4907
Provider Enumeration Date:
10/06/2006