Provider First Line Business Practice Location Address:
8750 GREENWOOD AVE N, S-1
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:
98103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-782-5789
Provider Business Practice Location Address Fax Number:
206-782-5794
Provider Enumeration Date:
08/27/2010