Provider First Line Business Practice Location Address:
JOSEPHINUM C/O CREW
Provider Second Line Business Practice Location Address:
1902 2ND AVE.
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-957-9570
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2020