Provider First Line Business Practice Location Address:
7343 28TH AVE SW
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:
98126-3312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-856-5122
Provider Business Practice Location Address Fax Number:
206-933-9304
Provider Enumeration Date:
06/30/2008