Provider First Line Business Practice Location Address:
1536 N 115TH ST STE 200
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:
98133-8400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-363-1004
Provider Business Practice Location Address Fax Number:
206-363-3548
Provider Enumeration Date:
10/25/2006