Provider First Line Business Practice Location Address:
12750 LAKE CITY WAY NE
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:
98125-4427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-283-1920
Provider Business Practice Location Address Fax Number:
425-283-5401
Provider Enumeration Date:
01/25/2006