Provider First Line Business Practice Location Address:
6987 PERIMETER RD S
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98108-3847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-521-1599
Provider Business Practice Location Address Fax Number:
206-521-1612
Provider Enumeration Date:
06/10/2010