Provider First Line Business Practice Location Address:
1127 10TH AVE. EAST
Provider Second Line Business Practice Location Address:
#5
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-325-6244
Provider Business Practice Location Address Fax Number:
253-529-1887
Provider Enumeration Date:
09/17/2014