Provider First Line Business Practice Location Address:
3224 NW 74TH 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:
98117-4738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-282-2831
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2008