Provider First Line Business Practice Location Address:
2111 N NORTHGATE WAY
Provider Second Line Business Practice Location Address:
STE 221
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133-9018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-363-8240
Provider Business Practice Location Address Fax Number:
206-363-8301
Provider Enumeration Date:
05/23/2006