Provider First Line Business Practice Location Address:
2150 N 107TH ST STE 105
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:
98133-1305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-363-5090
Provider Business Practice Location Address Fax Number:
206-364-1674
Provider Enumeration Date:
10/04/2006