Provider First Line Business Practice Location Address:
6013 ROOSEVELT WAY NE
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:
98115-6610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-734-2990
Provider Business Practice Location Address Fax Number:
206-420-0319
Provider Enumeration Date:
01/12/2007