Provider First Line Business Practice Location Address:
3320 W MCGRAW ST
Provider Second Line Business Practice Location Address:
#4
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-283-9910
Provider Business Practice Location Address Fax Number:
206-283-9935
Provider Enumeration Date:
09/29/2006