Provider First Line Business Practice Location Address:
1501 N 45TH ST
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:
98103-6708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-694-6700
Provider Business Practice Location Address Fax Number:
206-694-6777
Provider Enumeration Date:
02/15/2019