Provider First Line Business Practice Location Address:
3307 3RD AVE W
Provider Second Line Business Practice Location Address:
110
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98119-1940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-281-2231
Provider Business Practice Location Address Fax Number:
206-281-2674
Provider Enumeration Date:
02/06/2007