Provider First Line Business Practice Location Address:
6817 GREENWOOD AVE N
Provider Second Line Business Practice Location Address:
PHINNEY RIDGE PROFESSIONAL CENTER
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103-5227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-930-4251
Provider Business Practice Location Address Fax Number:
206-781-5229
Provider Enumeration Date:
02/05/2015