Provider First Line Business Practice Location Address:
226 S ORCAS 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:
98108-2407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-234-4296
Provider Business Practice Location Address Fax Number:
206-693-2786
Provider Enumeration Date:
03/20/2019