Provider First Line Business Practice Location Address:
5600 RAINIER AVE S STE 210
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:
98118-2445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-383-6111
Provider Business Practice Location Address Fax Number:
206-260-2741
Provider Enumeration Date:
05/29/2026