Provider First Line Business Practice Location Address:
929 N 130TH ST STE 6
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:
98133-7500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-547-5510
Provider Business Practice Location Address Fax Number:
206-547-5517
Provider Enumeration Date:
12/26/2006