Provider First Line Business Practice Location Address:
4517 CALIFORNIA AVE SW STE D
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:
98116-4903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-495-8237
Provider Business Practice Location Address Fax Number:
206-362-7152
Provider Enumeration Date:
08/07/2013