Provider First Line Business Practice Location Address:
2211 YALE AVE E
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:
98102-3416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-650-0206
Provider Business Practice Location Address Fax Number:
206-805-8301
Provider Enumeration Date:
02/15/2012