Provider First Line Business Practice Location Address:
1111 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:
98122-4205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-788-4024
Provider Business Practice Location Address Fax Number:
206-382-3507
Provider Enumeration Date:
10/20/2016