Provider First Line Business Practice Location Address:
2445 3RD AVE S
Provider Second Line Business Practice Location Address:
MS:31-680
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98134-1923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-229-2537
Provider Business Practice Location Address Fax Number:
435-572-5448
Provider Enumeration Date:
11/18/2013