Provider First Line Business Practice Location Address:
621 5TH AVE N STE B
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:
98109-4241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-217-2015
Provider Business Practice Location Address Fax Number:
206-217-2060
Provider Enumeration Date:
08/03/2009