Provider First Line Business Practice Location Address:
4400 37TH AVE S
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:
98118-1609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-296-4650
Provider Business Practice Location Address Fax Number:
206-296-0580
Provider Enumeration Date:
11/23/2006