Provider First Line Business Practice Location Address:
1600 E JEFFERSON ST STE A4
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:
98122-5656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-320-2600
Provider Business Practice Location Address Fax Number:
206-320-4054
Provider Enumeration Date:
07/27/2005