Provider First Line Business Practice Location Address:
847 NE 102ND 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:
98125-7419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-729-3916
Provider Business Practice Location Address Fax Number:
206-284-8736
Provider Enumeration Date:
04/16/2008