Provider First Line Business Practice Location Address:
5801 PHINNEY AVE N
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103-5862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-497-5326
Provider Business Practice Location Address Fax Number:
206-309-7493
Provider Enumeration Date:
07/28/2009