Provider First Line Business Practice Location Address:
2101 S JACKSON ST
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:
98144-2226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-252-2600
Provider Business Practice Location Address Fax Number:
206-743-3183
Provider Enumeration Date:
02/01/2013