Provider First Line Business Practice Location Address:
1120 HARVARD AVE
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:
98122-4206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-324-6990
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2007