Provider First Line Business Practice Location Address:
1001 KLICKITAT WAY SW SUITE 205
Provider Second Line Business Practice Location Address:
PSIP
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-622-7747
Provider Business Practice Location Address Fax Number:
206-467-1470
Provider Enumeration Date:
02/26/2007