Provider First Line Business Practice Location Address:
10416 5TH AVE NE
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:
98125-7402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-709-8999
Provider Business Practice Location Address Fax Number:
206-892-1919
Provider Enumeration Date:
05/15/2007