Provider First Line Business Practice Location Address:
1970 HARVARD AVE E
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:
98102-4250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-347-6059
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2012