Provider First Line Business Practice Location Address:
3722 S HUDSON 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:
98118-1920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-223-9578
Provider Business Practice Location Address Fax Number:
206-838-1851
Provider Enumeration Date:
01/14/2013