Provider First Line Business Practice Location Address:
4520 42ND AVE SW
Provider Second Line Business Practice Location Address:
#24
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98116-4240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-937-6481
Provider Business Practice Location Address Fax Number:
206-937-7043
Provider Enumeration Date:
06/15/2010