Provider First Line Business Practice Location Address:
142 NW CANAL ST
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:
98107-4933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-347-0777
Provider Business Practice Location Address Fax Number:
888-254-3281
Provider Enumeration Date:
02/20/2009