Provider First Line Business Practice Location Address:
6706 MARTIN LUTHER KING JR WAY S
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:
98118-3217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-722-6706
Provider Business Practice Location Address Fax Number:
206-722-6709
Provider Enumeration Date:
05/27/2011