Provider First Line Business Practice Location Address:
5725 38TH AVE NE
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:
98105-2208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-321-6075
Provider Business Practice Location Address Fax Number:
206-299-5028
Provider Enumeration Date:
09/16/2020