Provider First Line Business Practice Location Address:
4515 MARTIN LUTHER KING WAY S
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:
98108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-382-4119
Provider Business Practice Location Address Fax Number:
206-340-2100
Provider Enumeration Date:
09/06/2012