Provider First Line Business Practice Location Address:
6200 13TH AVE S
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:
98108-2706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-461-6943
Provider Business Practice Location Address Fax Number:
206-973-8656
Provider Enumeration Date:
11/08/2006