Provider First Line Business Practice Location Address:
401 NE NORTHGATE WAY
Provider Second Line Business Practice Location Address:
STE 530
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98125-6036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-364-2273
Provider Business Practice Location Address Fax Number:
206-364-2576
Provider Enumeration Date:
12/29/2009