Provider First Line Business Practice Location Address:
3222 CALIFORNIA 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:
98116-3305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-934-0477
Provider Business Practice Location Address Fax Number:
206-939-5556
Provider Enumeration Date:
04/11/2007