Provider First Line Business Practice Location Address:
1560 N 115TH ST
Provider Second Line Business Practice Location Address:
SUITE #212
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-363-2800
Provider Business Practice Location Address Fax Number:
206-363-2811
Provider Enumeration Date:
11/07/2006