Provider First Line Business Practice Location Address:
6002 28TH 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:
98115-7116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-355-4676
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006