Provider First Line Business Practice Location Address:
2602 NE UNIVERSITY VILLAGE ST
Provider Second Line Business Practice Location Address:
SUITE B (AT MARKET OPTICAL)
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98105-5023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-522-9323
Provider Business Practice Location Address Fax Number:
206-525-3841
Provider Enumeration Date:
08/04/2010