Provider First Line Business Practice Location Address:
10821 8TH AVE SW
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:
98146-2225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-205-7259
Provider Business Practice Location Address Fax Number:
206-205-3286
Provider Enumeration Date:
11/22/2006