Provider First Line Business Practice Location Address:
7101 MARTIN LUTHER KING JR WAY S
Provider Second Line Business Practice Location Address:
#209
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98118-3594
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-722-2218
Provider Business Practice Location Address Fax Number:
206-722-2211
Provider Enumeration Date:
10/06/2005