Provider First Line Business Practice Location Address:
3801 W GOVERNMENT WAY
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:
98199-1014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-793-5346
Provider Business Practice Location Address Fax Number:
206-282-3640
Provider Enumeration Date:
02/10/2010