Provider First Line Business Practice Location Address:
1914 N 34TH ST
Provider Second Line Business Practice Location Address:
STE. 100
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103-9058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-632-2023
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2006