Provider First Line Business Practice Location Address:
9950 14TH CT S
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:
98108-5035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-455-8333
Provider Business Practice Location Address Fax Number:
206-299-3833
Provider Enumeration Date:
06/06/2023