Provider First Line Business Practice Location Address:
3251 NW 64TH ST
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:
98107-2616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-720-3041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2006