Provider First Line Business Practice Location Address:
6727 MLK JR WAY S STE 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:
98118-3205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-785-5269
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2026