Provider First Line Business Practice Location Address:
619 N. 35TH ST.
Provider Second Line Business Practice Location Address:
#204
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:
206-579-7900
Provider Business Practice Location Address Fax Number:
360-697-2395
Provider Enumeration Date:
01/10/2007