Provider First Line Business Practice Location Address:
2817 NE 55TH ST
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:
98105-5529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-524-5444
Provider Business Practice Location Address Fax Number:
206-524-0709
Provider Enumeration Date:
02/09/2007