Provider First Line Business Practice Location Address:
1401 E JEFFERSON ST STE 501
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:
98122-5570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-324-2225
Provider Business Practice Location Address Fax Number:
206-324-5244
Provider Enumeration Date:
12/17/2025